小剂量奥氮平对盐酸度洛西汀疗效及恶心与呕吐的影响  

Effect of Small Doses of Olanzapine on Clinical Efficacy and Incidence and Severity of Nausea and Vomiting Induced by Duloxetine Hydrochloride

作　　者：钟智勇[1] 韩洪瀛[1] 黄泽萍[2] 张晋碚[1] 

机构地区：[1]中山大学附属第三医院精神科,广东广州510630 [2]中山大学附属第三医院超声科,广东广州510630

出　　处：《中山大学学报（医学科学版）》2013年第5期756-760,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2010B080701040)

摘　　要：【目的】了解小剂量奥氮平对盐酸度洛西汀疗效及恶心、呕吐副反应的发生率和严重程度的影响。【方法】将2009年1月至2012年10月来我科就诊的诊断为抑郁症或躯体形式障碍患者共268例,随机分为单用盐酸度洛西汀组(165例,其中抑郁症112例,躯体形式障碍43例)与盐酸度洛西汀联合使用小剂量奥氮平组(103例,其中抑郁症72例,躯体形式障碍31例)组,在治疗2周末和4周末采用汉密尔顿抑郁量表(HAMD)评估疗效,在治疗2周末采用治疗副反应量表(TESS)评估患者在消化道副反应发生率和严重程度上的差异。【结果】在治疗2周末和4周末,联合用药组疗效要明显优于单用度洛西汀组,两组比较有统计学差异(P<0.05)。在治疗2周末,小剂量奥氮平组在恶心及呕吐的副反应发生率上要低于单用盐酸度洛西汀组,差值有统计学意义(P<0.05);不同剂量水平奥氮平之间在恶心呕吐副反应发生率上未见统计学差异(P>0.05);奥氮平的止呕作用对所有患者均起作用。【结论】小剂量奥氮平有助于提高盐酸度洛西汀疗效并降低盐酸度洛西汀的恶心呕吐副反应发生率且不增加药物整体副反应水平。[Objective] To analyze the effect of small doses of olanzapine on the efficacy of duloxetine and the incidence and severity of nausea and vomiting induced by duloxetine hydrochloride. [Methods] A total of 268 patients, who meet diagnostic criteria of major depressive disorder and somatoform disorder, from January 2009 to October 2012, were randomly divided into duloxetine hydrochloride alone group （165 cases, including 112 major depressive disorder patients, 43 somatoform disorder patients） and duloxetine hydrochloride joint use of small doses of olanzapine group （ 103 cases, including 72 major depressive disorder patients, 31 somatoform disorder patients）. All patients were assessed at the first day and the end of two weeks and four weeks treatment on Hamilton Depression Scale （HAMD）, and after two weeks treatment, total scales of Treatment Emergent Symptom Scale （TESS） and the incidence and severity of nausea and vomiting were assessed. [ Results ] After two weeks and four weeks treatment, the scales of HAMD was significantly lower in duloxetine hydrochloride joint use of small doses of olanzapine group than in the duloxetine hydrochloride alone group. After two weeks treatment, the incidence of nausea and vomiting was significantly lower in duloxetine hydrochloride joint use of small doses of olanzapine group than in the duloxetine hydrochloride alone group, but no significant difference （P 〉 0.05） in the incidence of nausea and vomiting between different doses of olanzapine. Antiemetic effect of olanzapine work for all patients. [Conclusion] Small doses of olanzapine help to improve the clinical efficacy of duloxetine hydrochloride and reduce the incidence of nausea and vomiting induced by duloxetine hydrochloride, and do not increase the level of overalladverse reactions.

关 键 词：奥氮平 盐酸度洛西汀 疗效 治疗副反应量表 抑郁症 躯体形式障碍 

分 类 号：R749[医药卫生—神经病学与精神病学]